I wish you well.
It sounds as though you have exhausted all of the available "other" options.
In my opinion, the determining factors for proceeding with knee replacement are yours.
if the pain, loss of motion, weakness, and lack of mobility are compromising your quality of life, interfering with your work responsibilities, or are just too much to bear; you should seriously consider knee replacement.
I have had a right knee replacement and don't regret doing so.
Of course the replacement is not without risk and potential for complications, which you should discuss with your surgeon.
I put off having it done for almost 5 years due to the responsibilities of my position in the Army. In fact I did a nighttime combat equipment parachute jump the night before my fifth and final right knee scope. Yet, I still put it off for another 3 years.
I wouldn't advise waiting as long as I did. I returned to full time work as an Orthopedic Surgeon in about four weeks. Two years after the knee replacement, I was able to complete The National Ski Patrol training and have been doing that in addition to Hand Surgery since. The TKA takes about 2-3 years to get as good as it will optimally become.
For further information I would recommend that you purchase an excellent book called "The Knee Owner's Manual". It is written by a very good friend of mine, Jeff Falkel PT PhD. He wrote the book after having both of his knees replaced. It is very comprehensive, illustrated and a very enjoyable read.
You can purchase it on Amazon for about $20.
I hope that this has been helpful.
All great questions to reflect on when making a decision about whether to have surgery or whether to try and manage conservatively.
How does one know that it is time for knee replacement surgery? Here are some of the points of advice I give to my patients:
1. Does the pain occur every day?
2. Does the pain wake you up at night?
3. Does the pain keep you from the activities you need or want to do?
4. Do you have to limit your work activities due to your knee pain?
5. Do you find yourself declining to have experiences or do activities with friends and family because of your knee pain?
6. Do you find yourself saying "I can't" when asked to do active things or when you think about wanting to do active things?
7. Have you tried steroid (cortisone) injections and hyaluronic acid (rooster comb or
Gel) injections without relief or decreasing effectiveness?
8. Do you require pain medicine (NSAIDs or opioids) stronger than Tylenol on a daily basis?
9. Have you tried bracing (compression, correction of instability or bowing/knock knees) without relief?
10. Have you tried a supervised exercise or physical therapy program without relief?
11. If you are overweight, have you undergone weight loss without pain relief?
12. Do X-rays of you when you stand up show bone on bone (end stage) arthritis?
If you answer yes to all or most of these questions, then you are a candidate for knee replacement surgery. I recommend that you seek out a consultation with an orthopedic surgeon who is fellowship trained in or specializes in total joint replacement to discuss your options.
Thank you for your question.
Kenneth Brooks, M.D.
Charles Beck MD
Joseph E. Ronaghan, MD, FACS, FICS
Associate Professor, Dept. of Surgery
clean up surgeries, medications and injections AND you are having
limitations to your activities then you may be a candidate for knee
Pain is the primary indication of this surgery .
My primary focus is on conditions of the foot, but I do help my patients to address certain types of knee pain as it relates to the alignment of the lower extremity. It sounds like your knee situation is a bit more complex and chronic than that. It also sounds like you've already seen an orthopedist (or two or three!).
I would suggest getting at least another opinion or two from the top knee replacement specialists in your area. Ask them if there is arthritis in your knee that is severe enough to warrant a knee replacement. Also, ask them the chances of achieving at least temporary relief from hyaluronidase injections or even PRP or amniotic membrane injections.
I hope that's helpful!
Dr. Richard Graves
From the brief description, you may be a candidate for a knee replacement. However, I'm an academic orthopaedic surgeon and could never advise without seeing you, taking a detailed history, a complete knee examination and reviewing current X-rays including weight bearing views', then you get a well thought out and correct opinion.
Dr Clive Segil, M.D
X-rays and an examination will confirm the diagnosis of arthritis. Your surgeon can discuss the operative procedure, risks and expected outcome. Patients your age can be very active, if they do the appropriate amount of post operative physical therapy and muscle strengthening. This might include golf, bowling, biking, hiking, even skiing.